Corissa Vidal, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

G126019 Issued in IA

Practice address

1026 A Ave NE
Cedar Rapids, IA 52402-5036

Phone

(563) 503-0306

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Methodist HospitalGroup PAC ID 6608786751, 82 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.76 of 100Reported as group

Quality

75.82

Promoting interoperability

81

Improvement activities

40

Cost

75.88

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cvidal54778@direct.unitypoint.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Luke'S Methodist Hospital

  • Cardiovascular Disease Physician
  • Cedar Rapids, IA
  • NPI 1073553939
  Medicare reassignment Care Compare group NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• New Life Counseling PC

  • Mental Health Counselor
  • Ankeny, IA
  • NPI 1356479554
  NPD (past)
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1134570278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "563-503-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "563-503-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL",
        "first_name": "CORISSA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G126019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warren Neil Verdeck, MD
• Shannon Verwoert, O.D.
• Michelle L Vetsch, DNP
• Vexmora LLC
• Halee Vicks
• Vim Chiropractic and Wellness PLC
• Amy Vincent, ARNP
• Vine Christian Counseling
• Vision in Motion LLC
• Visiting Nurse Association of Linn County

• Psychiatric/Mental Health Nurse Practitioner in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.